KNOWLEDGE, INTELLIGENCE, AND WISDOM

 

Knowledge is the collection of facts, information and skill. It is typically gained through books, research, and delving into facts. These can be acquired at any age. They can be acquired either through reading, education or by doing. The word knowledge is defined first as the “acquaintance with facts, truths or principles, as from study or investigation; general erudition.” 

Intelligence can be defined as the ability to think logically, to conceptualize and abstract from reality. Intelligence is something, some say, we are born with. Intelligence can be acquired naturally. Or, it can be honed through learning. It takes intelligence to apply knowledge properly. Intelligence helps in:

• Better grades at school
• Higher-paying jobs
• Ability to think critically, analytically, and rationally
• Ability to make logical decisions
• Admiration by others (something highly desirable by grandiose narcissists)
• Ability to solve complex problems, e.g., involving mathematics or inductive or deductive reasoning.
• Ability to predict future outcomes based on knowledge of the appropriate data
• Less likely to get in trouble e.g., because of an understanding of crime and punishment

 

Wisdom can be defined as the ability to grasp human nature, which is paradoxical, contradictory, and subject to continual change. Wisdom can only be acquired through experience over time. It can be learned in youth through mentoring, but it more likely comes with learning by doing over time. Wisdom is defined as “the state of being wise,” which means “having the power of discernment and judging properly as to what is true or right: possessing discernment, judgement, or discretion.” It’s older (recorded before the 900s), and joins wise and -dom, a suffix that can convey “general condition,” as in ‘freedom, kingdom. When we think of the benefits of wisdom, they are plenty:

• Ability to discern right from wrong (also called intuition)
• Ability to view adversity as an opportunity for growth
• Being more accepting of uncontrollable life’s challenges and uncertainties
• Ability to spot danger from afar and avoid it
• Better sense of direction that comes intuitively
• Developing greater patience and therefore less likely to experience anxiety
• Greater vision and leadership skills
• Knowing how to attain peace, happiness, and contentment with greater ease

 

The two constructs, intelligence and wisdom, hold potential for highlighting positive and adaptive features of development in the later years. Both are considered to increase with age, and both provide for life-long acquisition of knowledge. As humans, we make decisions. Not all decisions are good. Virtually no one can make every single decision a good one. But knowledgeable, intelligent and wise people make more good decisions than bad ones. Knowledge, intelligence and wisdom are there for the taking for most, if one has the desire. The combination of traits does not, in itself, make a good person. But how one applies each of those traits can determine the type of person one becomes.

 

Differences between Wisdom and Intelligence

#1. Wisdom grows with age, but not necessarily intelligence: You might have heard the sentiment “The older, the wiser.” And there might be some truth to it. Greater wisdom is seen in older people’s ability to use a wider range of reasoning and consider different outcomes when faced with various scenarios. Those scenarios include making choices, resolving conflicts, dealing with uncertainties, and deciding when to take risks.

#2. Wisdom comes through life experience, unlike intelligence: “Experience teacheth wisdom,” at least that’s the age-old belief. It makes sense that we learn from experience, whether the experience was pleasant or unpleasant. We are wiser if we can use the knowledge gained, especially from bad experiences, to exercise sound judgment in the future. Intelligence is something you have to consciously work on improving. In fact, a person can be extremely intelligent yet lack experience in various areas as well as wisdom.

#3. Intelligence can be willfully improved, but not wisdom: You can read a book, take a course, or read for a degree and you’ll increase intelligence and knowledge just like that. You can’t wake up one day and say, I’m going to develop or increase my wisdom today, at least not exponentially. The only fresh wisdom you’ll gain is from new or different experiences you have on that day.

#4. Wisdom leads to second-nature decisions, unlike intelligence: The use of intelligence to make decisions requires the application of facts, logic, and/or reasoning. Besides, the individual will first have to be intelligent in order to engage in the process of logical thinking and use the result to make informed decisions. They may have to look up books or Coogle for tips.  The wise person relies on past experiences, patterns, and intuition, They also lean on their ability to make quick judgments from the facts and are able to come to a decision quickly, without relying on books or googling for tips. This is because the information is already stored in the brain from previous experience, they’re able to quickly draw from it and act accordingly.  

#5. Wisdom allows for self-reflection, intelligence may not: A person, young or old, can be as smart as a whip and still conduct themselves poorly because they lack the ability to self-reflect and gain awareness of their behaviors. For example, noticing they’ve acted impulsively, aggressively, or indulged in risky behaviors. The ability to regulate our emotions and maintain emotional stability also comes with age, time, experiences, and maturity.

#6. Intelligence can be measured, but not wisdom: There are Intelligent Quotient tests such as the Wechsler Adult Intelligence Scale (WAIS).  but do you know of a Wisdom Quotient Test that exists? There are none.

#7. Intelligence does things “by the book,” wisdom asks if it’s the right thing to do: Wisdom is more of an inner sensing ability or intuition that kicks in to question what you’re about to say or do before doing so. Intelligent people who lack wisdom may act impulsively by nature. By asking, “Is this the right and proper thing to do?” wisdom essentially turns to past experiences and core values, such as honesty and morality, for advice in order to determine the proper course of action.

 

The function of intelligence is characterized as focusing on questions of how to do and accomplish necessary life-supporting tasks; the function of wisdom is characterized as provoking the individual to consider the consequences of his actions both to self and their effects on others. Wisdom, therefore, evokes questions of should one pursue a particular course of action.

Many search for ways to become wise, but few feel they have really achieved it. The Berlin Wisdom Project of the late 80s defined wisdom as:

- Spiritual knowledge

- Factual knowledge

- Excellent judgment 

- Excellent problem-solving skills

- Ability to learn from past experience

- Humility, emotional strength or ability to recover from defeat

- Openness and maturity - allowing another to see you as you really are

- A deeper understanding of human nature, including empathy for others and other cultures  

 

How to become wiser in the human experience    

1. By Being Social:   People who keep more contact with other people display higher levels of wisdom than those who remain more secluded. Some think this may be due to new people constantly giving us new ideas to think about, new information, new experiences, and this enriches the mind and gives us more wisdom. So make an effort, if not for others than for yourself. Stay in touch with old friends, go take a course, and stay in contact with those around you, it's the wise thing to do.    

2. By Adopting Open-mindedness:    Wisdom is the ability to understand all aspects of a problem, without surrendering to personal feelings. Rabindranath Tagore said ‘Where the mind is without fear and the head in held high’! The meaning of an open mind is to find true empathy and to understand that everyone has a life story that affects them in some way, and it is not our place to judge. A good habit is to write down, every day, what ails you. At the end of the day, take a look at that list and try to get a new perspective on each problem, you'll be surprised what things will come to mind.      

3. By Acknowledging that "I could be mistaken":   A smart person understands that it is impossible to know everything and that life always throws you a curve when you least expect it. Acknowledging our mistakes may, and often does, lead to greater wisdom. Remember, your ability to be wrong shouldn't damage your reputation as a wise man but should increase it because wise people know how to take responsibility for their mistakes. Nietzsche is quoted to have said: "Wisdom sets limits on knowledge, too." Only a fool thinks he knows everything. Acknowledge the limits of your knowledge and admit when you are wrong.    

4.  By Experiencing new things:   While we each have our own personal tastes in books, music, art or movies, it is important to note that getting familiar with styles unknown will broaden your horizons and introduce new world views, new ideas and new outlooks on life. So put down the novel you're reading and try a science fiction story, a history book or just a great romance. Whatever it is you almost never read, now is the time to add some real experience in things you haven't really touched on. So try something new, or learn a new skill -  it won't just make you wiser, it'll also keep you young!

5. By Self-awareness:   Many will say they have rich life experiences, but when was the last time you really stopped to think of all you've learned throughout life?   Try this exercise: Write down your three biggest failures and your three biggest successes. Next to each of them write some of the events that lead to it and the lessons you learned. Look for patterns, without pride or regret, simple patterns to teach you about how you used each experience to drive you forward. After all, knowing yourself is the biggest challenge of all.    

6. By Knowing what is going on around you:   Yes, the news is often dramatic, misrepresented or just depressing. But it's hard to make balanced decisions for yourself and others if you don't learn from the mistakes of others and, on larger scales, of your city, country, and world. Keep updated, read a newspaper, watch the news or just read a news site online from time to time. Read the articles, not just headlines, and understand how you fit into this bigger world, and where you stand. This is crucial for true wisdom.

It takes intelligence to apply knowledge properly. Wisdom can only be acquired through experience. It can be learned in youth through mentoring, but it more likely comes with learning by doing over time. One can know a lot, and not apply what he or she knows intelligently. Knowledge and wisdom are two distinct concepts that are often used interchangeably but hold different meanings. While knowledge refers to the acquisition of information and facts, wisdom involves the application of knowledge along with experience, insight, and good judgment.

REMEMBERING PROF. S. N. CHAKRABORTY BY HIS FOOT NOTES

 

 

Recently while going through my medical school class notes, I came across a very interesting lecture delivered by my late Guru and a wizard of Medicine, Prof. S.N. Chakraborty. He was a genius. He would walk inside a class early morning and ask “What do you want to study today?” and once we or his Medicine Senior Resident, Dr. Sumanta Chakraborty, who would take our attendance before his arrival, would express our choice of chapter, he would start extempore. No notes, no preparation Prof. Chakraborty was a walking talking encyclopedia of Medicine. We were mesmerized by his knowledge and were in love with his thunderous laughter.

On that day someone in our class asked him to teach us about diseases of the foot and in this blog I am trying to summarize his teachings from my lecture notes. The Professor said that although “my feet are killing me!” is one of the most overused exaggerations in the entire world, the truth is that the condition of your feet can say a lot about the overall state of your health, as well as indicate any underlying diseases you may have. Reflexologists and massage therapists have been proponents of manipulating points on the feet to improve the health of internal organs for a very long time. Although the evidence to prove this is somewhat scant, it's true that a person’s state of health can be expressed through their feet.

In addition to containing a quarter of the entire human body’s bones, the feet also bear its entire weight. There are no less than 33 joints, 100 tendons, muscles and ligaments in them, as well as countless nerves and blood vessels that link to the heart, spine and brain. Taking the above into account, it perhaps isn’t a surprise to know that if there is something wrong with someone’s feet, the likelihood is that their entire body will be affected as well. Let’s take a look at a few things about the human body that can be revealed by the condition of the feet:  

1. Foot Cramping and Spasms

If you happen to get cramps and spasms in your foot, it could be a sign of a deficiency in your body. Spasms can be caused by dehydration, which occurs as a result of the muscles not getting enough oxygen. Another reason for muscles spasms could be that there is a lack or imbalance of electrolytes or nutrients in your body. If you experience spasms specifically when walking, then this could indicate a circulatory problem. A further reason for spasms to occur is overexertion, or failing to stretch adequately prior to exercising. Last but not least, the type of shoe you’re wearing may be causing you discomfort. If you’re a lady who happens to enjoy wearing sky-high heels, for instance, you should look more closely at your choice of footwear to see if they’re to blame for the spasms.  

2. An Enlarged Big Toe

Gout is the most common type of inflammatory arthritis in men, and it can cause the big toe to become red, hot, swollen and extremely painful. Gout occurs as a result of too much uric acid building up in bodily tissues and fluids. Its normal blood level is between 3.5 to 7.2 mg%. It’s also to blame for an increased risk of developing kidney stones. This type of inflammatory arthritis usually manifests itself in the big toe because uric acid crystals tend to collect in the coolest part of the body. Overweight or obese people are more at risk of developing gout, as well as those who drink excessive amounts of alcohol and/or consume lots of meat. Furthermore, certain medication like diuretics can exacerbate the risk.

3. Cold Feet

 Do your feet to tend to be abnormally cold? If they do, it could indicate that you have poor circulation, diabetes, hypothyroidisim or anemia. In addition, if your feet change color from red, to white, to blue, it could be a sign of Raynaud’s disease, which is a narrowing of the blood vessels when nerves overreact to the cold. Primary Raynaud’s sufferers are advised to avoid the cold and smoking tobacco, however 20% of all cases stem from an underlying disease. These people tolerate the winter months poorly.

4. Swollen Feet (Pedal oedema)

Swollen feet can be indicative of numerous health problems. It could be simple nutritional deficiencies like hypo-proteinemia, anaemia and Beri-beri (Vitamin1 or Thiamine deficiency) or life-threatening like poor circulation and related heart failure, kidney or liver disease. It could also be because of deep vein thrombosis, filariasis,  a blood clot, lymphatic build-up and cellulitis, among others. Try raising your feet when sitting down, exercising your legs, reducing your salt intake and avoiding tight clothes, if you happen to have swollen feet. Investigations for the causative diseases are advisable. 

5. Spoon-Shaped Toenails

Concave-shaped toenails aren’t just unsightly – they could also be a sign of something underlying. The primary thing it’s associated with is nutritional deficiencies. They’re also associated with genetic disorders, circulatory problems, autoimmune diseases and musculoskeletal conditions.

6. Colored Toenails

Conditions such as tuberculosis, jaundice due to liver problems, thyroid gland involvement and even sinusitis could all cause the toenails to yellow. Yellowed toenails can also be symptomatic of bronchiectasis, an infective lung condition that causes breathing problems. Different nail colors and textures could also indicate a whole range of various systemic problems.  Vitamin B₁₂ deficiency present as hyperpigmentation of nails like bluish discoloration of nails, blue-black pigmentation with dark longitudinal streaks, and longitudinal and reticulate darkened streaks.

7. Deformed, infected and destroyed toe nails

Fungal infection of the toe nails or Onychomycosis, usually seen in diabetics are a common cause of deformed nails.  If the nails are peeling, brittle, or have vertical ridges, this may be vitamin D deficiency should be considered. Recurrent nail bed infections – paronechoea should always be investigated for diabetes. Brittle nail that chip and break easily is associated with iron deficiency anaemia. White spots on the nails - sometimes called Beau's lines - are one of the important signs of a zinc deficiency.

8. Pins and Needles Sensation

Circulatory problems, peripheral nervous system damage, a trapped nerve and a range of other ailments can lead to numbness or tingling in the feet. Diabetics who are exposed high blood glucose for an extended period can also experience nerve damage, which in turn leads to tingling in the feet, which is called Peripheral Neuritis. Pins and needles in the extremities can also be one of the first symptoms of multiple sclerosis.

9. Aching Toe Joints

Some 90% of people who have rheumatoid arthritis will experience aching toe joints. The disease makes the lining of the joints swollen and inflamed. As a result, the joints and supporting ligaments and tissues are damaged, which ultimately leads to decreased mobility. Antiinflammatory drugs relieve these symptoms, but have their own side effects like gastritis. Furthermore, shoe inserts can help minimize pressure and correct the shape of the foot. Some people also have braces that they wear on their feet. Gout too is a cause of painful and swollen great toe joints.  

10. Hallux valgus and Bunion

This condition is characterized by misalignment of the big toe. This leads to the big toe pushing and exerting pressure on the surrounding toes making the big toe MCP joint to stick out and point outward. Bunions at this projected site are more common in women who have diabetes and are overweight.  

11. Corns and Calluses

Corns and calluses are thick, hardened layers of skin that develop when the skin tries to protect itself against friction or pressure. They often form on feet and toes or hands and fingers. If you're healthy, you don't need treatment for corns and calluses unless they cause pain. Offloading footwear can help patients who are severely distresses. Corn caps, which have salicylic acid can be used for a long time to get rid of them. Offloading footwear can help patients who are severely distresses. 

12. Planter fasciitis

Plantar fasciitis can cause pain in the bottom of your heel or in the lower part of your middle foot. This happens when the plantar fascia becomes strained because of soft-soled footwear with poor arch support, frequent standing, long-distance running, weight gain, or other foot conditions. Stretching exercises, alternate hot and cold foot bath and corrective footwear can effectively treat this condition.

13. Foot Drop

If you have difficulty lifting the front part of your foot, this could be a sign that you have drop foot, which is normally indicative of an underlying muscular, neurological or anatomical problem. The resultant gait is called ‘steppage gait’. Foot drop can occur as a result of a leg injury, faulty plaster immobilization damaging the lateral popleteal nerve or Sciatic nerve damage during a hip operation. It can also be the result of a neurological disease such as polio, as well as a brain or spinal cord disorder. A brace or splint can be used to help maintain a normal foot position, whereas nerve stimulation can also alleviate drop foot to a certain extent. Surgery can also be undertaken to treat nerves, fuse bones or transfer tendons.

14. Persistent Sores

If you have diabetes, it’s possible that you have experience nerve damage to some extent. Nerve damage, or neuropathy, results in people being unable to feel or notice injuries such as blisters and decreased vascularity prevents early healing. Diabetics are prone to foot ulcers both because of loss of sensation and because of decreased blood flow. Nerve damage can also cause feet and toes to change shape – Charcot foot. Dry, cracked and peeling skin on the feet can also be a sign of diabetes, as can calluses and poor circulation.

15. Madura foot

Madura foot, or mycetoma, is a chronic granulomatous infection characterized by subcutaneous masses, draining sinuses, and the presence of grains or granules in exudates. This condition is caused by either fungi or aerobic filamentous bacteria.  Surgical debridement, followed by prolonged appropriate antibiotic and antifungal therapy for several months is required to save the foot.

16. Deformed foot

Deformities can be since birth like Club foot, Syndactyly of toes, Hemimelia or shortening of lower limb. Acquired deformities can be because of trauma or because of chronic diseases like diabetes and Rheumatoid Arthritis. Diabetes is the commonest cause of amputation of foot or its digits is you take trauma out of the consideration.

 

The Professor concluded with the advice that if you miss to examine the feet of your patients, you may miss the diagnosis! The feet warrant more attention than you imagined. If you are a diabetic then take care of your feet more than your face.

Friends, this was one of Prof. Chakraborty’s many extempore lectures which we have enjoyed in our college days. Always smiling, with a twinkle in his eyes he not only knew the subject thoroughly but could organize it into a captivating lecture and could convey his message almost effortlessly. With no notes, no power point presentations, the sagacious grand old man was effervescent with knowledge and his love for teaching could only be matched by his wisdom. Remembering him today with great reverence and respect!

BEWARE OF SOCIAL MEDIA INFLUENCERS

 

 

I am sure you must have come across this recent species in the social media. They are called influencers. They are experts in everything. They know how to make quick money, how to cook the best dinner, which restaurant to go to, which foreign locale to visit, which property to rent or purchase, which dress will look best on you, which spectacle frame, lip shade and eyeliner will make you look like a wow, which stock to buy and even which man or woman to marry! I really envy their confidence, though not their knowledge. 

 

Facebook has stock market gurus growing all over it like rashes. The only problem is that they can be allergic rashes which can leave you poor and shattered if you go by their financial acumen to pick stocks. Why are they not getting rich themselves and so selflessly want me to get rich, I often wonder!

 

They get their traffic by identifying the most vulnerable soft spot of their target audience. Teenagers already suffering from body dysmorphia may fall deeper into Chiborg and other rabbit holes, becoming critically desperate to look a certain way. I don't mind a wonder cook advising how to cook the best Rajasthani Lal Mans, because the worst case scenario is even the street dogs will refuse your generous hospitality that day, but the guy who is peddling magic cure of diabetes or hypertension can wean you out of your physician's prescribed drugs and kill you!

 

Influencers can very easily indulge in disguised motivation for pitching a diet supplement or a real estate property or a stock and deprive you of both health and wealth. These fitfluencers and finfluencers if let loose on the society can create havoc and the government agencies must check their credentials and force them to undergo accreditation. They are not just a menace anymore, they are downright dangerous.

 

 

A positive impact

Genuine Social Media Influencers are individuals who have established credibility in a specific industry with access to a large audience and the power to persuade others to act based on their recommendations. They represent a new type of independent third-party endorser who shape audience attitudes through blogs, posts, tweets, and the use of other social media. I would be the first person to admit that Social media influencers are renowned for their quality and engaging content. Their positive impact is felt in areas such as mental health awareness, where they highlight its importance and offer people a platform to talk and vent their emotions. They also bring attention to the importance of sustainability, feminism, and animal welfare.

 

They have become incredibly popular in the last couple of years, and people have started looking up to them. Across categories such as fashion, tech, travel, food, or even parenting, they help people learn about the latest trends. They are also in a position to help people buy useful and effective products by posting authentic reviews and making smart choices. Moreover, influencers also support brands’ and small businesses’ grow by reaching out to a large audience, thus helping the country’s economy.

 

 

Who is a Social Media Influencer?

A Social Media Influencer may be anyone from a blogger to a celebrity to an online entrepreneur. Some of the top Social Media Influencers in India are celebrities such as Alia Bhatt, Ranveer Singh, Akshay Kumar, Disha Patani, or sports personalities such Virat Kohli, MS Dhoni. Social Media Influencers may not necessarily be celebrities only. The list of Social Media Influencers also includes fashion bloggers such as Diipa Buller Khosla, Santoshi Shetty or food bloggers such as Richa Hingle, Saransh Goila or comedians such as Kanan Gill, Kenny Sebastian, etc. International Social Media Influencers who have a huge follower base include Hudda Kattan (make-up expert), Cameron Dallas (song reviews), Kylie Jenner (modelling), Cristiano Ronaldo (football star) etc.

 

 

Influencer marketing

This is the newest form of marketing, consists of companies or agencies reaching out to Social Media Influencers for their brand promotional purposes. Nowadays companies engage in such strategy by sending social media influencers products free-of-charge so that they can post reviews or share a photo, invite them to attend events where everything is taken care of by the company, or share a certain message with their audience. A travel blogger may be invited to a 5 star resort for a free on the house weekend in exchange of a good review. A food blogger may not only get a free dinner for two but an extra remuneration for a favourable review.

 

 

The darker side

People worship social media influencers, treat them as mega-celebrities, create fan pages for them, and even send them expensive gifts. This has risen to blind faith, which has its own challenges. The other issue is that it has created disparity among businesses. Brands with a big marketing budget are able to get their products promoted by collaborating with larger social media influencers. This makes it difficult for small businesses and start ups with low marketing budgets to beat the competition.

 

Some social media influencers are also often seen posting inauthentic reviews to get more brand deals and generate revenue. Their audience, in turn, purchases products on their recommendation, leading to unnecessary hoarding of products and immense competition among teenagers.

 

Lastly, a certain section of social media influencers promote a life of luxury and independence, dismissing the idea of working sincerely 9-5. Then, on the other extreme, some influencers promote constant hustle, how one needs to be productive all the time. This can negatively impact the minds of young people who have just started their careers, setting wrong precedents for them.

 

 

Legal standpoint

This statement made by the Single Judge of the Bombay High Court brought into the limelight the impact and responsibilities of Social Media Influencers “Social Media Influencers, whether their audience is significant or small, impact the lives of everybody who watches their content. They do have a responsibility to ensure what they are publishing is not harmful or offensive.” 

 

A statement by a Social Media Influencer about a certain product may be construed as defamatory/disparaging by the brand. Then, the first test is to separate statements of fact from opinions. Opinions cannot form the legal basis of a defamation or disparagement lawsuit. Any person can have an opinion about a product/service, and freedom of speech allows him/her to express the same. However, if he/she were to state that a particular product can harm the user, then they are stating a fact. To establish defamation, in such cases, the burden would be on the company/brand to establish that the Social Media Influencer whom they were suing acted with “actual malice” i.e. the person acted recklessly, with full knowledge that their statement was false and with utter disregard for the truth.

 

A Social Media Influencer should never promote something that they don’t support or lie about a product to generate sales for the brand. This may harm their image and their trustworthiness, which in turn can erode their fan base. They cannot make up claims about a product that would require proof the advertiser does not have – such as scientific proof that a product can treat a health condition.

 

The Social Media Influencer ecosystem is all set to change soon. The government is thinking of releasing guidelines to bring more transparency and help protect consumer interests. This would mean a similar set of regulations, if not the same, will be in place to put sponsored influencer and digital creator posts on Instagram on the same page as regular advertising on digital platforms. A step towards regulation of such Social Media Influencers would be to follow the footsteps of many nations and adopt guidelines similar to the guidelines in those countries.

 

 

The creator economy, which comprises social media influencers, content curators, bloggers, and bloggers, is almost a decade old. The pandemic expedited the rise of social media influencers. In 2022, there were over 50 million social media influencers. Over 500k professional individual creators on Instagram have over 100k followers each. These people are considered active influencers. The number is only going to increase in the coming years, which means social media influencers’ impact on society will also grow. So, beware of them.

VITAMIN D DEFICIENCY

 

For all those who love to fall in the trap of whole body check-up that is offered by corporate hospitals, and all those who have an insurance policy that takes care of a bunch of pathology investigations, whether you need them or not, finding low levels of Vitamin D in your system is one of the commonest finding in urban India. This is true, there is a very good chance that we don't get all the Vitamin D we need. Just to soothe your nerves let me tell you that  about 42% of American adults are deficient in this vitamin too. So, what is going on? And, why should we be concerned?

 

Being deficient in vitamin D is associated with a number of health concerns including risk for Alzheimer's disease, diabetes, osteoporosis and heart disease.  Add to that, if you have been diagnosed with breast or prostate cancer, your chances of survival may be lower than someone with normal levels of vitamin D. This may sound alarming, though it shouldn't come as a surprise. After all, vitamin D isn't found in too many foods - with the exception of salmon and fortified milk and yogurt. The only other way to get the nutrient, is to expose your bare skin to the sun. But if you work indoors all day, this is highly unlikely. 

 

Why is Vitamin D important?

Vitamin D plays a crucial role in maintaining the balance of calcium in our blood and bones and in building and maintaining bones. More specifically, we need vitamin D so our body can use calcium and phosphorus to build bones and support healthy tissues.

With chronic and/or severe vitamin D deficiency, a decline in calcium and phosphorus absorption by our intestines leads to hypocalcemia (low calcium levels in our blood). This leads to secondary hyperparathyroidism (overactive parathyroid glands attempting to keep blood calcium levels normal). Both hypocalcemia and hyperparathyroidism, if severe, can cause symptoms, including muscle weakness and cramps, fatigue and depression.

To try to balance calcium levels in your blood (via secondary hyperparathyroidism), our body takes calcium from our bones, which leads to accelerated bone demineralization (when a bone breaks down faster than it can reform). This can further result in osteomalacia (soft bones) in adults and rickets in children. Osteomalacia and osteoporosis put you at an increased risk for bone fractures. Rickets is the same as osteomalacia, but it only affects children. Since a child’s bones are still growing, demineralization causes bowed or bent bones.

 

Who are at risk of Vitamin D Deficiency?

The best way to discover whether you are deficient in vitamin D is to take a blood test. Your levels should be between 45 to 50 µg/mL. So, who all should get tested for Vitamin D levels in blood? This is something you may want to consider if you form part of these groups:   

1. You are over 55. As we age, we tend to become less mobile, making it difficult to spend time outdoors, which would result in getting less vitamin D. In addition, ageing skin cannot synthesize vitamin D as efficiently. In fact in hospitalized adults with hip fractures often have have low levels of vitamin D in their blood. So, you're likely falling short on the nutrient unless you are taking a daily supplement. 

2. You work indoors, in an office. Working a 9 to 5 job would mean that you don't get much sun. Urban people with occupations that limit sun exposure are unlikely to obtain adequate vitamin D from sunlight. This makes supplementation and a smart diet key to staying healthy. Rural people who work in farms and fields get their share of Vitamin D and may not require supplementation.

3. You have dark skin. There are lower levels of vitamin D in those who are dark in complexion. This is because darker skin makes it more challenging for the body to produce vitamin D from sunlight. If you're darker skinned, you should rely on dietary sources of the nutrient, rather than sunlight to reach your daily vitamin D mark. So, you may not require Vitamin D if you are a Kashmiri, but will surely require if you are from the southern states.

4. You suffer from inflammatory bowel disease.  Vitamin D is a fat-soluble vitamin, this means its absorption depends on the gut's ability to take in fat. Fat malabsorption is associated with inflammatory bowel disease (IBD) - this includes conditions like Crohn's disease and ulcerative colitis. In fact, it has been shown that up to 70% of people with IBD have insufficient vitamin D levels, according to a Journal of Gastroenterology and Hepatology report. If you suffer from IBD, speak to your doctor and check whether you are getting enough vitamin D. 

5. You have a high body fat percentage. If your body mass index (BMI) is over 30 or you have a high body fat percentage, it may be more challenging for vitamin D to circulate throughout your body. Nevertheless, this doesn't mean that you will always be deficient. Be sure to speak to your doctor and find out just how much vitamin D you will need.

6. You are taking certain medications. Steroids such as prednisone, as well as weight-loss drugs like orlistat, and the cholesterol-lowering drug cholestyramine can impair vitamin D metabolism. Similarly laxatives, anti-epileptic drugs – Phenobarbital and phenitoin, and anti-tubercular drug Rifampicin also cause Vitamin D deficiency. If you take any one of these drugs, be sure to check in with your doctor to find out the best way for you to get the right dose. 

7. You suffer from depression. Did you know that people with low levels of vitamin D in their blood are more than twice as likely to be diagnosed with depression, than those with higher levels? Medical experts aren't sure why this is the case, however one hypothesis is that the vitamin may alter hormones and areas of the brain that affect and regulate mood. 

8. You suffer from chronic headaches. If you suffer from regular headaches, low blood levels of vitamin D may be to blame. The specific link between headaches and vitamin D remains unclear, researchers believe the nutrient may help combat the inflammation that causes migraines and headaches.

9. Weight loss Surgery. Those undergoing bariatric surgery are doing to suffer from a surgery induced malabsorption to reduce calorie intake. Vitamin D supplementation becomes vital in such situations.

 

How do we treat Vitamin D deficiency?

The goals of treatment and prevention for vitamin D deficiency are the same: to reach and then maintain an adequate vitamin D level in your body. While you might consider eating more foods containing vitamin D and getting more sunlight, your healthcare provider will likely recommend taking vitamin D supplements.

Vitamin D comes in two forms: D2 and D3. D2 (ergocalciferol) comes from plants. D3 (cholecalciferol) comes from animals. You need a prescription to get D2. D3, however, is available over the counter. Your body more easily absorbs D3 than D2.

Work with your doctor to find out if you need a vitamin supplement and how much to take, if needed. Exposure to sunlight is vital. But be careful about being in the sun for too long without sunscreen. Excessive sun exposure puts you at an increased risk for skin cancer.

The amount of vitamin D you need each day depends on your age. The average daily recommended amounts are listed below in micrograms (mcg) and International Units (IU).

Age / Life Stage	Recommended Amount
Infants up to 12 months old	10 mcg (400 IU)
People 1 to 70 years old	15 mcg (600 IU)
Adults 71 years and older	20 mcg (800 IU)
Pregnant and breastfeeding people	15 mcg (600 IU)

 

Source of Vitamin D

There are a few foods that naturally have some vitamin D, including:

• Fatty fish. such as salmon (Rawas), tuna (Kera) and mackerel (Aila / Bangada) and sardines (Tarli)
• Mushrooms.
• Egg yolks.
• Cod liver oil.

You can also get vitamin D from fortified foods. Be sure to check the nutrition labels to find out if a food has vitamin D. Foods that often have added vitamin D include:

• Cow’s milk and soy, almond and oat milk.
• Breakfast cereals.
• Orange juice.
• Other dairy products, such as yogurt.

Vitamin D is in many multivitamins. There are also vitamin D supplements.

 

Vitamin D is a nutrient we need for good health. It helps our body absorb calcium, one of the main building blocks for strong bones. Together with calcium, vitamin D helps protect us from developing osteoporosis, a disease that thins and weakens the bones and makes them more likely to break. Our body needs vitamin D for other functions too. Our muscles need it to move, and our nerves need it to carry messages between our brain and our body. Our immune system needs vitamin D to fight off invading bacteria and viruses. So, knowledge about this vitamin and awareness about its insufficiency and how to manage it becomes vital.